Opinion
ORDER
ALLISON CLAIRE, Magistrate Judge.
Plaintiff, a state prisoner proceeding pro se, has filed a civil rights action pursuant to 42 U.S.C. § 1983 together with a request for leave to proceed in forma pauperis pursuant to 28 U.S.C. § 1915. However, the certificate portion of the in forma pauperis application has not been filled out and signed by an authorized prison official. See 28 U.S.C. § 1915(a)(2). Plaintiff will be provided another opportunity to submit a fully completed application to proceed in forma pauperis. Plaintiff is cautioned that he must also provide a certified copy of his prison trust account statement for the six month period immediately preceding the filing of his complaint.
In accordance with the above, IT IS HEREBY ORDERED that:
1. The Clerk of the Court shall provide plaintiff with another copy of the Application to Proceed In Forma Pauperis By a Prisoner for use in a civil rights action.
2. Plaintiff shall submit, within thirty days from the date of this order, a fully completed in forma pauperis application. Plaintiff's failure to comply with this order will result in this action being dismissed without prejudice.